Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
An epidemic is defined as occurring when "new cases of a certain disease, in a given human population during a given time period, substantially exceed what is expected based upon recent experience." Pediatric obesity has reached epidemic proportions when compared with just 20 years ago. The goal of this article is to explore this phenomenon and understand the potential consequences should this pattern continue. The concurrent epidemic of adult obesity will not be addressed.
Childhood obesity facts
Adult and childhood obesity have increased substantially in the last 30 years. Currently, 35% of adults (78.6 million) and 18% of children 2 to 19 years old (12.7 million) are obese, as defined by their body mass index (BMI).
The vast majority of obesity represents an imbalance in calories ingested versus calories expended. Other causes of obesity (metabolic, medicines, and other diseases) are very rare.
Losing body fat requires both caloric restriction and daily vigorous exercise.
The immediate and long-term consequences of obesity include physical, psychological, and economic issues.
Obesity prevention will require both a personal and social/cultural change in lifestyle. The large volume of current research will help clarify what will be most helpful.
Recent evidence supports that child obesity rates have leveled off and are even decreasing in the younger age groups.
What is childhood obesity? How do health-care professionals diagnose
In order to systematically describe obesity, the concept of body mass index (BMI) was developed. BMI is the ratio between an individual's weight to height relative to their gender and age. BMI addresses the following question: Is the weight of the subject in excess of what is healthy for a given height? Generally (but not always), BMI correlates with the amount of body fat, but it is not a measurement of fat. An individual who has more than the average muscle mass for a given height (for example, weightlifters) will have an elevated BMI but clearly will not be obese. Nomograms for both adults and children have been developed to graphically represent the range of normal when measuring BMI. An individual is overweight when their BMI is between 25.0-29.9. Obesity is defined as a BMI greater than 30.0. Many web sites have calculators to measure BMI (for example, http://www.cdc.gov/healthyweight/assessing/bmi/). Measuring body fat may be done via skin-fold-thickness measurement, waist-to-hip-circumference ratio, and neutral buoyancy (water displacement) measurements. BMI is not used for children under 2 years of age, and instead growth charts should be used to identify any weight issues.
Q: I'm pregnant and have a family history of obesity. How can I prevent my child from becoming obese?
A: A report from the Institute of Medicine this year found
that one-third of American children and youths are either obese or at risk
for obesity. Over the past 30 years, the obesity rate has nearly tripled for
children 2-5 years old (from 5% to 14%) and youths 12-19 years old (5% to
17%), and it has nearly quadrupled for children 6-11 years old! We now know that
infants are at greater risk for obesity if their moms gain excessive weight